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If you look around your congregation and observe a swelling sea of silver, you are not alone. According to a 2019 report by Census.gov, 10,000 Baby Boomers turn 65 each day, and by 2030, “all baby boomers will be at least 65.” A FACT study revealed that in congregations across various denominations, 33 percent of participants are 65 or older. Our people are aging and approaching the last chapter of their earthly lives. Ministry leaders must help our people to end well: to face the reality of decline, dying, and death while preparing for glory spiritually, practically, and emotionally. As we equip those we shepherd to end well, we also prepare them to care for others at the end of life, that none might die “unbefriended.”1
Ending Well
My former mentor died as she lived, with her eyes fixed on her beloved Savior. Her final days differed little from her ordinary days before being diagnosed with terminal cancer. She spent her time living and sharing her core belief: because Jesus had saved her from sin and death and because she was united to him in death and resurrection, she was energized and called to love God and love others. In her last days, she laughed, cried, and played games with her grandchildren. She reminded her husband how long to stir the roux in the gumbo she had grown up eating. How did my friend end her life so well? By fixing her eyes on the glory that awaited and living her hope of glory in every numbered day of her life.
Not everyone maintains their cognitive health until the end of their lives. In such cases, ending well may have more to do with the preparation that took place before cognitive decline. For this reason, we urge our people to live intentionally before the days of decline and death arrive. We begin with the good news of the glory that awaits after death. We acknowledge the normal fear of death, pointing to the Savior who went before us in death to deliver us from our fear. (Heb. 2:14-15) We remind those God’s people of the joys that await in eternal glory: heaven, the welcome of Jesus, the arrival of the new heavens and the new earth, the resurrection of our bodies, the day of no more mourning, and the full enjoyment of the God who created us for worship.
We also prepare others to end well by equipping them to leave a practical, spiritual, and emotional legacy. We — pastors, counselors, teachers, and guest speakers — speak of the need for such legacies in sermons and Bible studies, offering classes and guest speakers, providing biblical guidance around medicalized dying, estate planning, expressing final wishes, and sharing a spiritual legacy. We make ourselves aware of biblical resources for such preparation and guide others to them. With this preparation, when the days of incapacitation or death arrive, there is no scurrying about, no hand-wringing by family members, no agonizing because of uncertainty about final wishes.
Practical Preparation
Bill Davis, philosophy professor at Covenant College and hospital ethics board consultant, shares scenarios from real-life examples in his classes and workshops. In one of his examples, Grant, the only living grandchild of 91-year-old Edith, faces a difficult decision. Edith suffers from confusion and has become a fall risk. Doctors have warned Grant that a fall could lead to Edith’s death and have recommended he hire a full-time sitter. Grant must decide: should he use the money he has saved for his children’s education and his retirement to pay for the sitter?
In discussing how Grant should honor Edith, Davis explains that a conversation well in advance of this scenario would have saved everyone much heartache. If Edith had clearly instructed Grant that he should never spend his own savings for her care, Grant would feel more peace about his decision. Because they had not had this conversation, Grant must try to imagine what Edith’s wishes would be if her mind were clearer.2 This scenario underscores an essential aspect of ending well: communicating wishes early and often. Ministry leaders can provide people with opportunities to have conversations about wishes regarding medical measures, financial stewardship, distribution of possessions, and end-of-life plans.
Medicalized Dying
Because the arena of so-called medicalized dying is rapidly changing, it is crucial to learn about end-of-life medical measures. Recognizing that a doctor’s primary goal may be to extend life on this earth, no matter the cost, we must remind people that with Christ as our Savior, life on earth is not the ultimate good. Keeping this perspective helps us all to make decisions about whether an end-of-life medical measure will sustain life or prolong death.
In his helpful book, “Departing in Peace: Biblical Decision-Making and the End of Life,” Davis explains how to apply biblical principles to making decisions about the many end-of-life medical measures—CPR, ventilators, artificial nutrition, chemotherapy, and more. He notes, “While the Lord has blessed us with medical advances to combat death, their efficacy depends on his mercy. He does not need our help, nor does he call us to pursue futile interventions to give him time.”
Once people learn more about end-of-life medical measures, they can prepare an advance directive, a legal document that indicates wishes for medical interventions at the end of life. They can appoint a healthcare proxy and have clear conversations with that person about their wishes. Our churches can lead people in this process by offering Sunday School classes or encouraging people to complete an online course in preparing this legacy material.
Wills
According to a Caring.com survey, the number of Americans with a will in 2024 is 32%, a 6% decrease since last year. Of those who do not have a will, 40% claim they don’t need one because of their lack of assets. Too many of us have heard or been part of a story of heartache and family bickering that resulted from the lack of a clearly-written will. People must understand that whether they have a lot or a little, expressing wishes for distribution of assets is not only a kindness to loved ones, but also a key principle of financial stewardship. Preparing a will acknowledges that the Lord has showered us with material gifts and possessions and is a way to steward those possessions wisely even after we’re gone.
Digital Legacy
A digital legacy includes passwords and information about online accounts and possessions. A financial power of attorney or an executor often needs passwords in order to pay bills in the case of incapacitation or death. A well-organized computer file, a handwritten list, or a digital password manager will help the responsible parties to handle finances, to close accounts, and to cancel subscriptions. It can also provide access to essential information about insurance, retirement accounts, and credit cards.
End-of-Life Wishes
Additionally, we can help people communicate their wishes for the disposition of the body and end-of-life services, ideally well in advance of their death. We must offer wise biblical counsel about these matters, because in the absence of such counsel, people will turn to the internet and social media for guidance. There they may find counsel that denies the dignity of the human body made in the image of God, or counsel that proposes end-of-life services that focus only on the deceased. We can design and offer guides for planning end-of-life services that help people to grieve their loss while pointing them to the hope of glory and the goodness and sovereignty of God.
Spiritual Legacy
In addition to encouraging people to leave the information, documents, and instructions that will help loved ones in the case of cognitive decline or death, we must also urge them to be intentional about leaving a spiritual legacy. A spiritual legacy includes the stories, expertise, blessings, and wisdom that help us tell “the coming generation the glorious deeds of the Lord.” (Ps. 78:4) Spiritual legacies may include writing letters or blessings to survivors, passing on a skill or expertise, or compiling a collection of stories, values, and wisdom. Some churches have connected youth with elder members of the congregation for interviews about their lives. Such an exercise benefits all generations. Spiritual legacy workshops and retreats can provide valuable opportunities for people to recognize how God has worked redemptively throughout their lives.
Emotional Legacy
We can also lead people to consider the emotional legacy they want to leave. In his insightful book, “The Four Things That Matter Most,” Ira Byock, a palliative care physician, offers his “recommendations for mending, tending, and celebrating relationships” at the end of life. He commends four powerful sentences: “Please forgive me.” “I forgive you.” “Thank you.” “I love you.”3
In the final chapter of the book, Byock adds a fifth task: saying goodbye. Although we might not call it an emotional legacy, Jesus himself completed many of these tasks before the end of his life. In the Upper Room Discourse he said goodbye to his disciples, expressed his love, and offered instructions, comfort, and prayer. (John 13-17) He called on his Father to forgive those who betrayed him even as he hung on the cross. (Luke 23:34) He honored his mother by placing her in John’s care. (John 19:26-27)
All Christians are called to carry out the tasks of leaving an emotional legacy throughout our lives. As we minister to people at the end of life, we encourage them to be intentional about completing the emotional legacy tasks, reminding them that the power for such tasks comes from our union with Christ. Such a legacy points others to Christ while imparting comfort, peace, and hope.
Ministering to the Dying
Having helped God’s people begin preparing for the end of life far in advance, we can also equip them to care for people who are diagnosed with a terminal illness and who are actively dying.
To minister well to the dying, we must first recognize the isolation many people with terminal (or chronic) illness endure. They are left alone when others withdraw, fearful of saying the wrong thing or irrationally believing that death is contagious. We must encourage and equip others to minister to the least of these so that no person is ever left “un-befriended” as they die.
Processing a Diagnosis
Hospice nurse and PCA-ordained pastor Chris Accardy urges us to create space for people to process a diagnosis. As he explains, when people are diagnosed with a terminal illness, they are often overwhelmed with a flood of medical information about treatment plans. When we have educated ourselves and others about end-of-life medical measures as mentioned above, we can help those we shepherd make wise decisions about which treatments to pursue.
Spiritual Doubts
Accardy also points out that dying people often struggle with spiritual doubts, even questioning God’s goodness. He explains that the disease process and even treatment can affect emotions; pastors and those offering care should not “belittle people for experiencing these emotions” he says. We can instead listen without offering trite answers, while pointing people to biblical lament, assuring them that “The Lord is near to the brokenhearted and saves the crushed in spirit.” (Ps. 34:18)
The Hope of Glory
Furthermore, because we live with the hope of glory, we can help shift the focus from cure to hospice care at the appropriate time. Hospice is available to people when doctors believe they have six months or less to live. It provides a team of physicians, nurses, social workers, counselors, and chaplains, all of whom are equipped to care for dying patients. The team recognizes the physical signs of the patient’s final days and hours, manages the pain that can accompany dying, and attends to the spiritual and practical needs of the dying person and their loved ones.
Whether or not a dying person chooses hospice, we follow the lead of Jesus’s family and friends who offered compassionate presence as he died. We pray with and for the person with all types of prayer—adoration, praise, confession, lament, thanksgiving, supplication. As we listen and pray and ask appropriate questions, we help the dying person leave the emotional legacy mentioned earlier. We sing with and over the dying person, and we ask for and listen to their stories.
The silver tsunami is coming, and with it, the opportunity to share the hope of glory, now and forever. More and more, the people we pastor, counsel, and befriend will know in their very bodies the truth that the “outer self is wasting away.” (2 Cor. 4:16) And yet, we must point them to the greater truth that “this light and momentary affliction is preparing for us an eternal weight of glory beyond all comparison.” (2 Cor. 4:17) The apostle Paul points us to a day when grief will give way to glory—eternal, shining glory. As our hearts, no longer clouded by sin, take in the full breadth and depth of Christ’s glory, we will finally and fully be like him. (1 John 3:2) May we ourselves prepare for this day of future glory, and may we prepare those we lead. For he says, “Behold, I am coming soon!” (Rev. 22:20)
Elizabeth Reynolds Turnage is a life and legacy coach, a member of the PCA Older Adults Ministry Team, the author of Preparing for Glory: Biblical Answers to 40 Questions on Living and Dying in Hope of Heaven, and the co-founder of the Organizing Your Life and Legacy Course.
1. This term comes from author and physician, L.S. Dugdale, who explains that in the hospital, people without family or friends are labeled “unbefriended.” L. S. Dugdale, The Lost Art of Dying: Reviving Forgotten Wisdom (New York, NY: HarperCollins, 2020), 68.
2. William C. Davis, “Honoring Our Parents When They Decline Cognitively | Bill Davis,” General Assembly, accessed December 15, 2023, https://pcaga.org/project/honoring-our-parents-when-they-decline-cognitively-bill-davis/.
3. Ira Byock, The Four Things That Matter Most – 10th Anniversary Edition: A Book About Living (Simon and Schuster, 2004), 7.